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Breast Procedures

Breast Augmentation With
No Scar on the Breast®

Importance of Choosing Your Surgeon Carefully

Because fiber-optic endoscopic technology is a recent advance and requires specialized training and skill to use, you may find that few surgeons offer breast augmentation using the transaxillary (underarm) technique. Surgeons who are unfamiliar with or unable to perform this procedure tend to steer patients away from the underarm technique even though it is well suited to most patients and types of breast implants. For this reason alone, it's important to choose a surgeon such as Dr. Burden or Dr. Ennis who regularly performs this type of surgery.

Our No Scar on the Breast Specialists

When you choose Destin Plastic Surgery for your breast augmentation, you can be confident that your procedure will be performed by an expert in the No Scar on the Breast technique, either Dr. Burden or Dr. Ennis.

One of the most common concerns women have about breast augmentation is the tell-tale scars it leaves behind. Dr. Burden pioneered and perfected an innovative breast augmentation technique called, "No Scar on the Breast®" technique that leaves only a tiny scar in the crease under each arm. Dr. Ennis joined Dr. Burden in 2003 to learn this technique, and together, they have made this procedure available to women around the country and around the world. Miss USA & Miss America contestants, Playboy models, country music performers, and bathing suit models to mention a few, have had their procedures performed by Dr. Burden and Dr. Ennis.

Our experienced, innovative plastic surgeons make it possible to have beautiful, natural-looking breast augmentation results with No Scar on the Breast. To get started, request a consultationrequest a consultation online or call our office at (850) 654-1194. Located in Destin, Florida, we provide first-class services for patients from surrounding cities, neighboring states, and international locations.

Our SpecializedTechnique

When performing breast augmentation with the No Scar on the Breast technique, Dr. Burden or Dr. Ennis inserts a narrow fiber-optic camera, called an endoscope, through a small incision in a natural crease of the underarm. The endoscope allows the surgeon to see inside the surgical area on a monitor as he creates a pocket for the breast implant beneath the breast. The magnified image enables the surgeon to clearly see the surgical field and create a pocket that precisely fits the implant while minimizing bleeding.

Our surgeons also use an innovative device called a Keller Funnel™ to insert the implant into the pocket without directly touching it. The Keller Funnel not only makes it easier and safer to place silicone implants through the shortest possible incision, but it also it minimizes the risk of infection.

No Scar on the Breast (Transaxillary) Incision

Note the well-healed incision (right) that is "hidden" in the crease of the armpit and barely visible 3 months after surgery using the No Scar on the Breast technique.

Advantages of the Transaxillary Technique

Dr. Burden and Dr. Ennis understand that most women considering breast augmentation want a natural look. Women including models, celebrities, and professional athletes travel from around the world to for the transaxillary technique performed by our renowned plastic surgeons. Advantages of this technique include:

  • No scar on the breast. Incisions placed beneath the breast are visible in string bikinis. Incisions around the areola are visible when topless. This technique leaves no evidence of surgery on the breast.
  • Incisions are well hidden. The incision is placed in one of the natural creases in the underarm. If the scar is noticeable at all, most people don't associate a scar in the underarm with breast augmentation.
  • Attractive, natural-looking results. The armpit incision enables our surgeons to insert the breast implants beneath the chest muscle in an innovative "dual plane" placement. This placement provides a full, soft, natural breast shape especially along the lower portion of the breast because the upper portion of the implant is hidden beneath the chest muscle and the lower portion lies directly beneath the breast tissue.
  • Option of either silicone or saline implants. While other surgeons often limit patients to saline implants for the transaxillary approach, our surgeons offer the option of silicone as well. In fact, they routinely place silicone implants through the armpit and have been doing so much longer than other surgeons.
  • Enhanced recovery. When placing breast implants under the chest muscle, the transaxillary technique may make recovery easier than other techniques as the chest muscle can be "lifted" to insert the implant instead of being cut. Breast tissue is also not cut with this technique.
  • Optimal incision healing. Incisions that are not under tension typically heal most cleanly and rapidly. When the incision is around the areola or in the breast crease, the breast implant can create outward pressure (tension); this is not the case with the armpit incision.
  • Lower risk of infection. The transaxillary technique completely avoids the breast glands, which may contain bacteria and cause infection. Use of the Keller Funnel enables the breast implants to be placed without direct contact, further reducing the risk of infection.

Common Concerns About the Transaxillary Technique

If you choose a plastic surgeon with experience in endoscopic breast augmentation, it's highly likely you will end up with beautiful results from the transaxillary technique. Unfortunately, common misconceptions about this approach exist mostly because of misinformation from people and surgeons not experienced with this technology. Common concerns include:

Breast Implants Won't Drop
This is a pretty common misconception regarding transaxillary breast augmentation prior to the advent of fiber-optic technology. With this new technology, implant placement is more precise. The location of the incision has nothing to do with implant "dropping" unless your surgeon is not experienced with this technique, in which case the surgeon may not create the pocket correctly.

Can't Be Used for Silicone Implants
As adjunct breast implant study investigators, Dr. Burden and Dr. Ennis have had the opportunity to place silicone implants using their transaxillary technique for many years before other surgeons. Their superior experience enables them to analyze the breast and place silicone gel implants more precisely, with less trauma to the body – often in just 20 to 30 minutes. Our surgeons have assembled a breast augmentation surgical team that is very experienced with this procedure and has maintained a 0% infection rate with this approach.

Creates a Wide Cleavage Area
Many women worry that with the transaxillary incision they will end up with breast implants placed too far apart and no cleavage. Actually, cleavage depends on a woman's individual anatomy, not the incision used during surgery. However, a plastic surgeon who is not experienced with this incision may unnecessarily create a wide cleavage area.

Breast Implants Fall to the Sides When Laying Down
Natural breasts fall to the sides when a woman lies down. If the pocket is created incorrectly, the implants can fall into the armpits instead. This problem is usually the result of an inexperienced surgeon and can actually happen with any incision placement.

Dr. Burden

  • Performed more than 4,500 "No Scar on the Breast®" procedures to date.
  • Performed the first endoscopic breast augmentation at The University of Florida and in Northwest Florida (1995).
  • Has given International and National presentations to plastic surgeons specializing in breast surgery.
  • Published articles on his technique and has given International presentations and is currently writing a text on the procedure.
  • Is well known for using the "No Scar on the Breast®" technique for repairing breast surgeries using the endoscopic technique.

"After searching the internet, I found Dr. William Burden. He had been performing the endoscopic breast augmentation for 20 years and had done numerous surgeries through the underarm approach. ... I flew from Washington, D.C. to Destin, Florida. ... I underwent the surgery through the underarm approach and had the saline implants removed and replaced with silicone implants. The results were much better than I expected and better than my original results."

– Patient of Dr. Burden who underwent breast implant exchange

Dr. Ennis

  • Performed more than 3,000 endoscopic breast augmentation procedures to date
  • Participated in adjunct study to gain experience with silicone implants
  • Has spoken to international audiences of surgeons on the complexities and subtleties as well as the artistic elements of performing endoscopic breast augmentation as well as repairing complex revision surgeries in breast augmentation

"Not only is Dr. Ennis a talented surgeon, but his bedside manner is just as exceptional. He made me feel very comfortable with the procedure, implant size, and at all of my post op visits. He sat down at every appointment and made me feel like he had all the time in the world to answer my questions."

– Breast augmentation patient of Dr. Ennis on

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